| NPI | 1477968519 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT24844) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT14032) | 
| Enumeration Date | 2014-06-27 | 
| Last Update Date | 2014-06-27 |